NEW YORK (Reuters Health) Apr 04 - Clinical history and the use of computer models are not helpful in distinguishing organic from functional dyspepsia, according to a report in the Journal of the American Medical Association for April 5th.

"Current data suggest that a patient's dyspeptic symptoms appear inefficient for diagnosing the presence or absence of disease, even when the symptoms are modeled in a computer analysis or assessed by a gastroenterologist," lead author Dr. Paul Moayyedi, from McMaster University in Hamilton, Ontario, and colleagues note.

The findings are based on an analysis of data from 15 studies, published between 1983 and 2003, which included 11,366 patients evaluated for dyspepsia. Of these subjects, 4817 were classified as having organic dyspepsia.

When the clinician or computer model suggested an organic etiology for dyspepsia, the likelihood ratio of this being the actual diagnosis was 1.6. Conversely, when they suggested the absence of organic dyspepsia, the likelihood ratio was 0.46.

The clinician and computer model had a likelihood ratio of 2.2 when suggesting the presence of peptic ulcer disease and a ratio of 0.46 when suggesting its absence. Similarly, the corresponding ratios for esophagitis were 2.4 and 0.50.

"These results point to the diagnostic difficulty of identifying functional dyspepsia, peptic ulcer disease, and esophagitis," the researchers note.

"Future research should evaluate whether adding response to interventions, such as acid suppression to the clinical history, improves diagnostic accuracy across a broad spectrum of patients," they add.